Immunization Schedule

This schedule of recommended immunizations may vary depending upon where you live,
your child's health, the type of vaccine, and the vaccines available.

Some of the vaccines may be given as part of a combination vaccine so that a child
gets fewer shots. Talk with your doctor about which vaccines your kids need.

Birth

HepB: Hepatitis
B vaccine. Ideally, the first dose is given within 24 hours of birth, but kids not
previously immunized can get it at any age. Some low birth weight infants will get
it at 1 month or when they're discharged from the hospital.

4 months

6 months

Hib: This third dose may be needed, depending on the brand of
vaccine used in previous Hib immunizations.

PCV

RV: This third dose may be needed, depending on the brand of
vaccine used in previous RV immunizations.

6 months and annually

Influenza (Flu):
The flu vaccine is recommended every year for children 6 months and older:

Kids younger than 9 who get the flu vaccine for the first time (or who have only
had one dose before July 2018) will get it in two separate doses at least a month
apart.

Those younger than 9 who have had at least two doses of flu vaccine previously
(in the same or different seasons) will only need one dose.

Kids older than 9 only need one dose.

The vaccine is given by injection with a needle (the flu shot) or by nasal spray.
The flu shot is preferred for children of all ages because it has been shown to be
safe and effective. Although the nasal spray was not used in recent years, a changed
version of it is now recommended (for the 2018–2019 flu season) for kids who
may otherwise not get a flu shot. The nasal spray is only for healthy people ages
2 through 49. People with weakened immune systems or some health conditions (such
as asthma) and pregnant women should not get the nasal spray vaccine.

6–18 months

12–15 months

12–23 months

15–18 months

DTaP

4–6 years

DTaP

MMR

IPV

Varicella

11–12 years

HPV: Human papillomavirus
vaccine, given in two shots over a 6- to 12-month period. It can be given as early
as age 9. For teens and young adults (ages 15–26 in girls and ages 15–21
in boys), it is given in three shots over 6 months. It's recommended for both girls
and boys to prevent genital warts and some types of cancer.

Tdap: Tetanus, diphtheria, and pertussis booster. Also recommended
during each pregnancy a woman has.

16–18 years

Meningococcal B vaccine
(MenB): The MenB vaccine may be given to kids and teens
in two or three doses, depending on the brand. Unlike the meningococcal conjugate
vaccine, which is recommended, the MenB vaccine is given at the discretion of the
doctor.

Special circumstances

HepA can be given as early as 6 months of age to babies who will
travel to a place where hepatitis A is common (they will still need routine vaccination
after their first birthday). It's also recommended for kids 2 years and older and
adults who are at high risk for the disease. This includes people who live in, travel
to, or adopt children from areas with high rates of hepatitis A, people with clotting
disorders, people with chronic liver disease, homeless people, and drug users. The
vaccine also can be given to anyone who wants immunity to the disease, and is useful
for staff at childcare facilities or schools, where they may be at risk of exposure.

The MMR vaccine can be given to babies as young as 6 months old
if they will be traveling internationally. These children should still get the recommended
routine doses at 12–15 months and 4–6 years of age, but can get the second
dose as early as 4 weeks after the first if they will still be traveling and at risk.

The flu vaccine is especially important for kids who are at risk
for health problems from the flu. High-risk groups include, but aren't limited to,
kids younger than 5 years old and those with chronic medical conditions, such as asthma, heart problems, sickle
cell disease, diabetes, or HIV.

The meningococcal vaccines can be given to kids as young as 8
weeks old (depending on the brand of vaccine) who are at risk for a meningococcal
infection, such as meningitis. This
includes children with certain immune disorders. Kids who live in (or will be traveling
to) countries where meningitis is common, or where there is an outbreak, should also
get the vaccine.

Pneumococcal vaccines also can be given to older kids (age 2
and up) who have conditions that affect their immune systems, such as asplenia or
HIV infection, or other conditions, like a cochlear
implant, chronic heart disease, or chronic lung disease.

An outbreak is when a disease happens in greater numbers than expected in a particular
area. If you have questions about vaccinating your family during an outbreak, ask
your health care provider or contact your state or local health department.